The Canadian Journal of Psychiatry

Volume 50

Ottawa, Canada, June 2005

Number 7

Guest Editorial

High Society: Drugs, Mental Health, and the History of

Psychiatry
David Wright1

sychiatrists and historians used to exist in a state of mutual

mistrust and suspicion. Professional historians of a generation ago, much influenced by the radical epistemology of
Michel Foucault (1), the sociological critiques of Erving
Goffman (2), the countercultural theorizing of RD Laing (3),
or the trenchant libertarianism of Thomas Szasz (4), came to
portray the entire enterprise of modern psychiatry as a thinly
veiled experiment in social control and professional monopolization. French-language scholars such as Robert Castel (5)
and Yannick Ripa (6), as well as Anglo-American academics
from David Rothman (7) and Andrew Scull (8) to Phyllis
Chelser (9) and Elaine Showalter (10), constructed stinging
histories of the rise of psychiatry (and its asylums), ripping
into almost every aspect of modern psychiatric theory and
practice. Psychiatry was attacked, from the left and from the
right, by Marxists, feminists, and libertarians alike, as well as
from within its own ranks. Little wonder, as Trevor Turner,
the distinguished British psychiatrist-historian, remarked,
that many psychiatrists retreated from engaging with their
own history when it seemed that historians were preoccupied
with framing psychiatry as the culprit responsible for most of
modern societys social problems (11).

In the late 1980s, however, a leading medical historian, Roy

Porter (12), and a philosopher-psychiatrist, German Berrios
(13), sought a rapprochement by promoting a constructive

The Canadian Psychiatric Association acknowledges support in part for

the In Review series courtesy of an unrestricted educational grant from

M e n tal H e alth M atte rs

Can J Psychiatry, Vol 50, No 7, June 2005 W

exchange of scholarship between academic humanists and

clinician-researchers (14). Their project was realized in the
British-based journal History of Psychiatry (established in
1990). Psychiatric journals such as the London-based Psychological Medicine soon followed suit, integrating historical
articles within their pages. This new collaboration between
psychiatrists and historians was also aided indirectly by new
research in the philosophy of science that tried to break down
the simplistic dualism of biological determinism vs social
constructionism. In particular, the former University of
Toronto scholar Ian Hacking made a particularly thoughtful
case for creating a space for dialogue between the 2 camps
(15). His work affirms the existence of psychiatric illness in
the face of transtemporal diagnostic discordance.
It may come as a surprise to many readers that much of the
new scholarship in the history of mental health and psychiatry
is home-grown, emerging from Canadian universities.
Edward Shorters eminently readable A History of Psychiatry
(16) has been become a standard text on the emergence of the
mental health professions in the Western world; Geoffrey
Reaumes unconventional history of the Toronto Asylum
breaks new theoretical ground by rewriting the history of the
mental hospital from the perspective of the patients (17).
Thierry Nootens (18) and Marie-Claude Thifaults (19)
exploration of familial responses to madness in 19th-century
Quebec have opened up as-yet-unexplored vistas onto the history of care of the mentally ill outside the walls of the asylum
(18). A new anthology, encompassing the work of both prominent and promising scholars in the field, will soon be published by McGillQueens University Press (20).
This issues In Review section seeks to add to this new and
innovative research by exploring one small but vitally
371

The Canadian Journal of PsychiatryGuest Editorial

important corner of the history of psychiatry: the history of

drugs and mental health in postwar North American society.
In the first article, Andrea Tone, Professor of History and
Canada Research Chair in the Social History of Medicine at
McGill University, analyzes the rise of (minor) tranquilizers
within North American society as a treatment for anxiety (21).
She details the changing social and political context that
framed and informed the social practice of drug taking. Tone
also emphasizes the role that the media and (ultimately) politicians played in encouraging and then stigmatizing the users of
the new anxiolytics.
Many of the same forces are also held up for scrutiny in the
second article. Erika Dyck, a final-year doctoral student at
McMaster University, examines the controversial history of
LSD experimentation in postwar Canada (22). Her research
on LSD trials in Saskatchewan offers an outlook on the history of psychedelic psychiatry different from the perspective that has traditionally focused on Ewen Cameron, the CIA,
and the Allan Memorial Institute. In this piece, Dyck demonstrates that LSD research was not marginal but, rather, represented one of several promising new avenues of psychiatric
research concerning the modelling of schizophrenia and the
treatment of chronic alcoholism. However, like the fate of
tranquilizers in the 1970s, the social and professional uses of
LSD became overwhelmed by shifting cultural discourses and
the politicization of the use of psychoactive drugs.
These complementary contributions speak to the relevance of
historical research to current psychiatric knowledge and practice. The 2 articles involve debates that are crucially important
today: who controls psychoactive substances, the meaning
and nature of scientific evidence, and the multiple motives of
researchers. Rather than present a tidy conclusion to their own
research objectives, both authors highlight the ambiguity and
complexity that is an unavoidable, but also fascinating, part of
the history of mental health. Moreover, they point to the
enduring importance of analyzing the social contexts of scientific research and clinical practice. As Tone eloquently
explains in her own contribution, In the age of biological

372

psychiatry, social, political, and economic circumstances continue to be as important as biochemical responses in deciding
a drugs fate (21, p 375).

References
1. Foucault M. Folie et draison: histoire de la folie B lage classique. Paris (FR):
Plon; 1961.
2. Goffman E. Asylums: essays on the social situation of mental patients and other
inmates. New York: Anchor/Doubleday; 1961.
3. Laing RD. The politics of experience and the bird of paradise. London (UK):
Penguin; 1967.
4. Szasz T. The myth of mental illness: foundation for a theory of personal conduct.
London (UK): Harper; 1961.
5. Castel R. Lordre psychiatrique: lge dor de lalienisme. Paris (FR): Minuit;
1976.
6. Ripa Y. La ronde des folles: femmes, folie et enfermement au XIXe siPcle,
1838-1870. Paris (FR): Aubier; 1986.
7. Rothman D. The discovery of the asylum. Boston (MA): Little Brown; 1971.
8. Scull A. Museums of madness: the social organisation of insanity in
nineteenth-century England. London (UK): Penguin; 1979.
9. Chesler P. Women and madness. New York: Avon Books; 1973.
10. Showalter E. The female malady: women, madness and English culture,
1830-1980. New York: Pantheon; 1985.
11. Turner T. Dogma or stigma? Why are psychiatrists so bad at trying to be good?
Paper presented at specialist workshop on ethics, history, and mental disorder;
2004 May 15; University of Warwick, Warwick (UK).
12. Porter R. Madness: a brief history. Oxford (UK): Oxford University Press; 2002.
13. Berrios G. The history of mental symptoms: descriptive psychopathology since
the nineteenth century. Cambridge (UK): Cambridge University Press; 1996.
14. Berrios G, Porter R. [editorial]. History of Psychiatry 1990;1:12.
15. Hacking I. The social construction of what? Cambridge (MA): Harvard
University Press, 1999.
16. Shorter E. A history of psychiatry: from the era of the asylum to the age of
Prozac. New York: John Wiley; 1997.
17. Reaume G. Remembrance of patients past: patient life at the Toronto Hospital
for the Insane, 18701940. Toronto (ON): Oxford University Press; 2000.
18. Nootens T. Famille, communaut et folie au tournant du siPcle. Revue
dhistoire de lamerique franHais, 53, 1999.
19. Thifault M-C. Citoyennes de St-Jean-de-Dieu: Lenfermement asilaire des
femmes au Qubec: 1873-1921. ThPse prsente B la Facult des tudes
suprieures et postdoctorales B titre dexigence partielle en vue de lobtention du
doctorat en histoire, Ottawa (ON): Universit dOttawa; 2002.
20. Moran J, Wright D, editors. Mental health and Canadian society: historical
perspectives. Montreal/Kingston: McGillQueens University Press.
Forthcoming.
21. Tone A. Listening to the past: history, psychiatry, and anxiety. Can J Psychiatry
2005;50:37380.
22. Dyck E. Flashback: psychiatric experimentation with LSD in historical
perspective. Can J Psychiatry 2005;50: 3818.

1
Hannah Chair in the History of Medicine and Associate Professor,
Department of Psychiatry and Behavioural Neurosciences/Department of
History, McMaster University, Hamilton, Ontario.

W Can J Psychiatry, Vol 50, No 7, June 2005